The 5-Minute Briefing: The Angolan outbreak of Marburg disease

The world's worst outbreak of the lethal disease has infected 235 people in Angola, of whom 215 had died, the World Health Organisation said yesterday. The outbreak began last October but accelerated this month. The previous worst outbreak occurred in the Congo in 1998-2000 when 123 people died.

What is it?

A viral haemorrhagic fever that kills most of those infected. Like the Ebola virus, it is a filovirus and spread by contact with skin, blood and bodily fluids. Hence the efforts to discourage the custom of hugging the dead followed by local people in Angola's north Uige province.

Is there a cure?

No. The only treatment is supportive care to nurse the patient through the illness. There is no vaccine to prevent it.

What happens to the victims?

Five to 10 days after infection, they develop a fever with headache, nausea, vomiting and diarrhoea. Within a few days, haemorrhagic symptoms appear with bleeding under the skin as cells break down, from the nose and mouth and from puncture wounds made by needles. During the second week patients either begin to recover or develop fatal multi-organ failure.

Where does it come from?

Central Africa. Outbreaks start in people who have had close contact with monkeys, but monkeys die from the disease as quickly as humans so scientists believe there must be some other living thing which carries the virus but is not made ill by it.

Why is it called Marburg disease?

Because it was first identified in monkeys from Uganda in a German laboratory in Marburg in 1967. There have been six outbreaks since.

Could the disease spread beyond Africa and cause a global epidemic?

Unlikely. Although deadly, Marburg and Ebola disease remain concentrated in narrow geographical areas in Africa and transmission requires close physical exposure to those infected. Moreover, when patients become infectious they are already too unwell to travel, limiting the spread of the disease. Diseases such as avian flu could be global epidemics because they are spread much more readily through the air.

What is the best defence against the disease?

To isolate patients and educate local people in basic hygiene. In Angola, efforts to contain the outbreak have been hampered by hostility from local people to medical teams.

What has happened in Uige province?

An isolation ward set up in the province's main hospital specially for the care of Marburg patients stands empty, the WHO said yesterday, as families are loath to surrender their infected loved ones. A WHO spokesman said: "It is apparent that, for the time being, the community does not accept the concept of isolation." The WHO said that it may have to distribute disinfectants to relatives.